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Bulimia nervosa, more commonly known as bulimia, is an eating disorder. It is a psychological condition in which the subject engages in recurrent binge eating followed by an intentional purging. This purging is done in order to compensate for the excessive intake of the food and to prevent weight gain. Purging typically takes the form of:

The following six criteria should be met for a patient to be diagnosed with bulimia[1][2]:

The patient feels incapable of controlling the urge to binge, even during the binge itself, and consumes a larger amount of food than a person would normally consume at one sitting.

The patient purges him or herself of the recent intake, resorting to vomiting, laxatives, diuretics, exercising, etc.

The patient engages in such behavior at least twice per week for three months.

The patient is focused upon body image and desperate desire to appear thin.

The patient does not meet the diagnostic criteria for anorexia nervosa. (Some anorexics may demonstrate bulimic behaviours in their illness: binge-eating and purging themselves of food on a regular or infrequent basis at certain times during the course of their disease. Alternatively, some individuals might switch from having anorexia to having bulimia. The mortality rate for anorexics who practice bulimic behaviors is twice that of anorexics who do not. [3])

The patient is of normal weight or overweight.

Please note that, in general, diagnostic criteria are considered a guide. A legitimate clinical diagnosis can be made when the majority of the criteria are met.

The frequency of bulimic cycles will vary from person to person. Some will suffer from an episode every few months while others who are more severely ill may binge and purge several times a day. Some people may vomit automatically after they have eaten any food. Others will eat socially but may be bulimic in private. Some people do not regard their illness as a problem, while others despise and fear the vicious and uncontrollable cycle they are in [4].

The specific subtypes differ in the way the bulimic relieves themself of the binge.

Purging type - The purging type uses self-induced vomiting, laxatives, diuretics, enemas, or ipecac, as a mean of rapidly extricating the contents for their body. This type generally is more commonly found, and can use one or more of the above methods on a regular basis [5].

Non-Purging Type - This type of bulimic is very rarely found (only approximately 6%-8%), as it is a less effective means of ridding the body of such a large number of calories. This type of bulimic engages in excessive exercise or fasting following a binge in order to counteract the large amount of calories previously ingested. This is frequently observed in purging type bulimics as well, however this method is not their primary form of weight control following a binge [6].